Common questions you might ask your midwife might include:

What is your rate of cesarean section? Episiotomy? Forceps birth? Use of drugs and anesthesia?

Individual practices, both private practices and those in public hospitals, keep their own statistics on these elements of birth. The information provides a measure, separate from formal studies, of how those doctors and nurse-midwives work and their outcomes. As you shop, these statistics can provide you with a basis for comparing practices, and may indicate the amount of intervention during a typical childbirth. An episiotomy rate over 80 percent probably means the cut is made almost automatically, except when delivery is so rapid that there is no time. A high rate of epidural anesthesia tells you that medicated birth is the norm, perhaps even before anyone knows whether human touch, encouragement and other non-medical interventions are enough to get a woman through labor. The cesarean rate indicates your likelihood of a surgical birth.

Some avoid answering these questions directly, by saying that they do the procedures only as necessary. Ask for specific numbers. Remember, you are the consumer buying the services, and you have a right to know what to expect. Do not think you will beat the odds. If 90 percent of the patients have episiotomies, you probably will too.

Do you require or recommend prenatal testing and sonograms?

The response suggests how much input parents have during pregnancy, and shows to what degree parents' opinions are sought. Some women find that the healthcare professional who seems relaxed about well-woman care works more defensively when it comes to childbirth. To ensure that they will not be blamed for a child's handicaps, some healthcare professionals recommend testing or present it as the norm. This attitude is something to consider if you want to make your own testing decisions.

What role will my birth partner play?

It is standard now for a father or birth partner to remain with the laboring woman throughout labor and delivery, although the amount of participation varies. Ask if s/he is welcome at prenatal visits and whether s/he can stay with the mother if s/he wants to in the event of a cesarean.

How much time do you allot to each prenatal visit, and how long is a typical wait in the anteroom?

Look around the waiting room and ask women who are well into pregnancy how long they usually wait. If your blood pressure shoots up at every visit because the wait is making you late for work, your pregnancy will not be enhanced.

If you feel rushed or intimidated asking these questions, do not think it will be any different a few months down the road when you want to know about protein in your diet or what you can do about your swollen ankles.

On the other hand, if you find yourself getting more excited about the pregnancy as you speak with your midwife, and if he or she inspires your confidence and trust, this may be the right caregiver for you.

You might also want to ask these questions to evaluate the credentials and standards of practice for your midwife:

• Do you have a college degree?
• Did you graduate from a nationally accredited midwifery education program?
• Did your midwifery education require preparation in core sciences such as biology, chemistry, anatomy and physiology, microbiology, psychology, sociology, epidemiology/statistics, pathophysiology, and nutrition?
• Are you licensed to practice?
• How will you determine if I am an appropriate candidate for midwifery care and what will happen if I need the care of a physician?
• Are you prepared to provide well-woman and gynecological care, including screening for common health problems and writing prescriptions?
• Have you passed a national certification examination?
• Are you certified by the ACNM Certification Council?